Sona Kirakasian
Individual provider Active NPI Family Nurse Practitioner · Burbank, CA
NPI 1780356402 · NPPES record last updated Oct 18, 2024
Key facts
- NPI
- 1780356402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95007013 (CA)
- Practice address
- 511 N Hollywood Way
Burbank, CA 91505-3406 - Phone
- (866) 398-2727
- NPI assigned
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Minuteclinic Diagnostic Medical Group of California Inc
Practice addresses (Care Compare)
14735 Ventura Blvd
Sherman Oaks, CA 91403-3673
Phone (866) 389-2727
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211222000227 | CA | Practitioner - Nurse Practitioner | 9335530674 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95007013 | CA | MD | Family Nurse Practitioner |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic Primary Care California | Family | Current |
Accepting new patients |
| Minuteclinic Diagnostic Medical Group of San Diego Inc | Family | Current |
Accepting new patients |
| Minuteclinic Diagnostic Medical Group of California Inc | Family | Current |
Accepting new patients |
Locations
1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210
8850 Valley View St
Buena Park, CA 90620
Phone (714) 827-7321
511 N Hollywood Way
Burbank, CA 91505
Phone (818) 841-0710
2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221
14735 Ventura Blvd
Sherman Oaks, CA 91403
Phone (818) 788-0208
29610 Rancho California Rd
Temecula, CA 92591
Phone (951) 699-0192
2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95007013 | CA | Yes |
Addresses
Primary practice location
511 N Hollywood Way
Burbank, CA 91505-3406
Mailing address
14735 Ventura Blvd
Sherman Oaks, CA 91403-3679
Phone (818) 788-0208
Other providers in Burbank, CA
- Su Kim
- Yeseo Kim
- Tonya King
- Annabelle Kinna
- Paula Kinsey
- Karine Kirakosyan
- Elizabeth Kirby
- Tessa Ann Kirk
- Alice Susan Kiselyuk
- Sheldon Kishineff
All providers in Burbank, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.